Dr. Death takes the form of an attractive young woman in Miele, an impressively mature directing debut from Italian actress Valeria Golino, who crafts an often engrossing character study around an assisted suicide activist. Perhaps not surprisingly, the focus is more on character and performance than narrative, and the storyline tends to lag behind lead Jasmine Trinca’s cold-blooded idealist who helps the terminally ill pass on. Golino’s cool, glancing direction remains carefully neutral in the euthanasia debate and should capture audiences on both sides of the controversy, with its bow in Cannes’ Certain Regard bound to boost art house interest.

Skirting both the farcical treatment often afforded euthanasia stories and the intimately motivated drama of an Amour or Million Dollar Baby, Miele is more interested in the psychological toll taken on a particularly committed practitioner, Irene (Trinca), whose code name is Miele (Honey.) She works for her ex-lover (Libero Di Rienzo), a hospital physician who gives her the contacts of patients wanting to accelerate their end. Since assisted suicide is completely illegal in Italy, the slender, mannish Irene lives the shadowy existence of an undercover agent, flying all the way to Mexico buy lethal drugs sold as veterinary products to suppress dogs. The use she will make of them is quite different.

There’s no denying the morbid fascination of watching her in action, and the film offers several presumably typical scenes that detail the rules of her profession. In the first instance, she gives lucid, dispassionate instructions to a distraught man on how to poison his sick wife. Before the elderly woman drinks the fatal glass, Irene slips on surgical gloves, puts on their favorite music and notes “it’s possible to stop the procedure at any time.” They don't. Two later scenes follow the same pattern, their heart-breaking atmosphere undercut by the lovely but sinister angel of death hovering in the background.

The real film, however, is about Irene’s progressive de-humanization and alienation from other people, including her married lover (Vinicio Marchioni), who arranges trysts in the family station wagon complete with a baby seat. Golino and co-screenwriters Francesca Marciano and Valia Santella show strong sensitivity towards Irene’s inner battle between her convictions and her private life. Given the marginality of the euthanasia angle, Trinca’s character could just as well have been an abortionist, executioner or spy, as long as she was convinced she’s performing a socially useful job with a range of psychosomatic side effects. The turning point comes when she's sent to help a cynical, bored architect (Carlo Cecchi) end his existential pain. When she discovers he’s not ill, just sick of living, her morals rebel.

Cecchi, one of Italy’s top stage actors who rarely appears in films, brings a sardonic gravitas to a role that, like his relationship to Irene, never sinks into the predictable but always surprises. His earthy directness is a welcome backhand to the girl’s earnest belief system. In short hair and boyish togs, which she pulls off and on with a skinny model’s nonchalance, Trinca (The Son’s Room, The Best of Youth) gives her character a modern Euro feeling, equally devoid of sentimentality and sexuality. Though her face is photographed from every angle to the point of being fetishized, it’s too cool to betray much, and she uses the hyper-activity of her lithe swimmer’s body to express intense, building anxiety.

Golino is one of the few Italian thesps to have successfully crossed over to international work in films like Rain Man and Frida Kahlo; here she puts experience to good use in sophisticated, fleeting images snatched in bits and pieces by cinematographer Gergely Poharnok. The uncredited choice of songs feels very personal.